Allergen Labeling Research Articles

Quantitative risk assessment of allergens leaching from menstrual hygiene products

Allergic contact dermatitis (ACD) often associated with the topical use of perfumed products, remains one of the most common chronic skin disorders in Western countries. Since labelling of scented menstrual hygiene products (MHPs) is not mandatory, women might be unknowingly exposed to allergens. Given that vaginal mucosae lack the vital barrier function of the skin, skin allergens can easily penetrate and become systemically available and hence women may experience adverse effects in the anogenital region. The aim of this study was therefore to investigate whether women using scented MHPs are at risk of sensitization and hence developing ACD. Hereto, a Quantitative Risk Assessment (QRA) is performed on four well-known skin sensitizing chemicals (α-isomethyl ionone, benzyl salicylate, hexyl cinnamaldehyde and heliotropine) that were previously found leaching from five different scented MHPs including tampons and sanitary pads. The amounts of heliotropine, leached by one of the investigated tampons, exceeded acceptable exposure levels determined with the QRA and could induce sensitization. In addition, although no sensitization is expected for the other three compounds, an allergenic reaction might be provoked in women who are already sensitized. Labelling of allergens on scented MHPs would therefore help consumers to prevent adverse effects linked to ACD.

Transitioning peanut oral immunotherapy to clinical practice.

Peanut allergy is on the rise in industrialized countries, affecting 1%–4.5% of children and generally persisting into adulthood. It is associated with a risk of severe anaphylaxis and is one of the major causes of food allergy-induced deaths. Health-related quality of life is significantly impaired for patients and affected families due to food restrictions attributable to omnipresent precautionary allergen labeling, constant risk of potentially life-threatening reactions, and limitation of social activities. Oral immunotherapy (OIT) has emerged as a valid treatment option for patients with IgE-mediated peanut allergy, with randomized controlled trials and real-life studies showing a high rate of desensitization and a favorable safety profile, especially in young children. Ultimately, the decision to initiate peanut OIT relies on a multidisciplinary shared decision-making process, involving open, personalized and evidence-based discussions with patients and their caregivers.

A Chinese-Specific Reference Amounts Study With TNO Food Allergen Risk Assessment Models - China, 2022.

What is already known about this topic?There are no consistent regulations on possible unintended allergen presence in food. The Netherlands Organization for Applied Scientific Research (TNO) has been committed to developing a quantitative risk assessment methodology for the unintentional intake of allergens.What is added by this report?This study aims to derive the optimal food consumption point for a deterministic food allergy risk assessment under the TNO framework based on Chinese national consumption data. A case study has been presented as an illustration.What are the implications for public health practice?A robust evidence-based food consumption input in quantitative risk assessment of unintended allergens is necessary for future public policy on Precautionary Allergen Labeling for specific products to meet the safety objectives and to be adequately conservative.

Quantitative risk assessment for food allergy and the issue of allergen labelling

Quantitative risk assessment for food allergy and the issue of allergen labelling

Optimization of a sample preparation workflow based on UHPLC-MS/MS method for multi-allergen detection in chocolate: An outcome of the ThRAll project

Developing reliable methodologies for detecting and quantifying allergens in processed food commodities is crucial to support food business operators in allergen risk assessment and properly implementing precautionary allergen labels whenever required to safeguard the health of allergic consumers. Multiple Mass Spectrometry (MS) methods have been developed so far and applied for single and multi-allergen detection in foods, generating a heterogeneous literature on this topic, with little attention paid to the extraction and the digestion steps, crucial in delivering accurate allergen measurements.This investigation carried out within an international consortium specifically built up to convey a prototype MS based reference method, reports on the first part of the method development, namely the optimization of the sample preparation protocol for six allergens detection (cow's milk, hen's egg, soy, peanut, hazelnut, and almond) in chocolate. The latter was chosen as model complex food matrix, having a high lipid and polyphenol content.Different steps of the sample preparation protocol have been taken into consideration: (i) sampling, (ii) composition of the extraction buffer, (iii) protein purification, (iv) protein enzymatic digestion, (v) peptide purification and pre-concentration, and some experiments were carried out by two independent laboratories and two different MS platforms to provide a first assessment of the robustness of the method under development. Fifty target peptides were monitored in multiple reaction monitoring mode and validated in different laboratories to trace the six allergenic ingredients in the incurred chocolate and the best performing protocol for sample preparation was identified. This work paves the way of the forthcoming full analytical validation of a prototype reference method for MS-based allergen quantification.

On-campus food purchase behaviors, choice determinants, and opinions on food availability in a Spanish university community

ObjectiveThe aim of this study was to investigate food purchasing behaviors, choice determinants, and opinions about on-campus food availability by a university community and to analyze differences in these aspects between students, education and/or research staff (ERS), and administrative and services staff (ASS), and between males and females. MethodsThis was a cross-sectional study that involved a representative sample of students (n = 1089), ERS (n = 396), and ASS (n = 300) who completed an anonymous online survey. A previously adapted version of the questionnaire was administered. The results were weighted to ensure representativeness of this community population using weighted coefficients. ResultsThe results showed that most of the participants purchased food on campus (91.6%), especially for lunch (67.4% of foods and 37.4% of drinks) and snack (65.4% of foods and 45.4% of drinks). Hot drinks (i.e., coffee, tea, hot chocolate etc.; 60.5%), bottled water (49.2%), and hot foods (i.e., small servings [38.2%] and sandwiches/hamburgers [31.7%]) were the most purchased items. Taste (98.6%) was the most important determinant in choice, followed by price for students, nutritional value for ASS, and health value for ERS. The “top 5” opinions suggested for the campus food environment and potential changes were “greater capacity to access free filtered drinking water”, “greater capacity to recycle food packaging,” “more healthy options in vending machines”, “discounts for healthy choices,” and “allergen labeling.” ConclusionInterventions that improve sustainability and the affordability of products with high nutritional quality, price-manipulation directives, and allergen information on labeling would be well received among this community.

A practical focus on sesame allergy and a brief review of other seed allergies.

Although seed allergies are relatively rare, sesame allergy has been increasing worldwide and is typically persistent in most patients. Because allergen labeling laws, until just recently, have not required the declaration of sesame as a major allergen, there is a clear need to better understand and potentially treat this food allergy. Although blood and skin prick testing for sesame have limited predictive value, this improves with the use of component diagnostics and skin-prick test with fresh sesame. A thorough history and oral food challenge should be used to diagnose sesame allergy. Treatment of sesame allergy with oral immunotherapy has been demonstrated to be safe and effective in case reports, and in at least one controlled study with a published sesame oral immunotherapy protocol. There is minimum literature with regard to management of other seed allergies.

Spent fowl as a source of unintentional egg proteins exposure in Canadian food products

The occurrence of egg proteins in products containing spent fowl manufactured under current practices was studied to assess the risk these food products may pose to egg-allergic consumers and to determine if Precautionary Allergen Labelling (PAL) was recommended. Spent fowl slaughtering and processing operations in 2 Canadian facilities were observed. Raw hen pieces (n = 134), coming from 2 facilities, and intermediate and processed products containing spent fowl (n = 57), coming from one facility, were analyzed using ELISA. All samples tested positive for egg proteins. Raw pieces were tested using a qualitative method (i.e., swabbing); estimated egg proteins concentrations suggest the presence of highly contaminated samples (>600 mg/kg in 2 hen wing samples). Swabbing was found to be efficient for rapid detection of eggs in raw hen pieces, but not for quantification. A comparison between swab and grind results showed that egg proteins concentration is underestimated by at least a factor 2 for whole carcasses and a factor 10 for breast, wings and drumsticks, when using the swab protocol. For intermediate and processed products, quantitative measurements indicate that egg protein levels were below 16 mg/kg. Additionally, 88 water samples from chiller tanks were analyzed and indicate that this step could be the cause of the global contamination observed with an increase in egg protein concentrations overtime during the production schedule. As egg contamination is not adequately controlled under the current good production practices, the use of PAL would be recommended for raw spent fowl products.

Development and Validation of a Quantitative Method for Multiple Allergen Detection in Food Using Concatemer-Based Isotope Dilution Mass Spectrometry.

Accurate food labeling is essential to protect allergic consumers. However, allergen contaminations may occur during the whole food production process. Reliable, sensitive, and robust methods for detecting multiple allergens in food are needed. This work aims to develop and validate an LC coupled to tandem mass spectrometry (MS/MS) method for the detection and quantification of hazelnuts, peanuts, milk, and eggs in processed food products. In-house-produced incurred test materials, cookies and chocolates, were used for the method development and validation. The quantification was based on the standard addition strategy using qualified reference materials as allergen protein standards and an innovative stable isotope-labeled concatemer as an internal standard. A method targeting 19 allergen-specific peptides was developed and validated in two laboratories, which strengthens its robustness. The AOAC INTERNATIONAL performance requirements for repeatability, intermediate precision, reproducibility, and recovery were reached for at least one peptide per allergen across both matrixes, and quantification limits complied with the action levels of the Food Industry Guide to the Voluntary Incidental Trace Allergen Labelling (VITAL®) Program Version 3.0. The combination of incurred test materials, standard addition strategy, and stable isotope-labeled concatemer as an internal standard allowed us to develop and validate a robust method for detecting and quantifying multiple allergens in food with sufficient sensitivity to protect allergic consumers. The combination of characterized incurred test material, calibration with certified reference material, a single stable isotope labelled concatemer and cross-lab validation result in the required standardization and harmonization in food allergen detection according to the stakeholders' group to assess the robustness of our method.

Allergen action levels for food industries as risk management tools for a better use of precautionary Allergen labelling

Providing guidance to generate allergen action levels for food industries is important to assess the need for precautionary allergen labelling (PAL). Allergen action levels (in mg of allergen per kg of food commodity) were computed based on the eliciting dose (ED) of each selected allergen divided by consumption distribution data. Canadian consumption data was extracted from the Canadian Community Health Survey of 2015, representative of the general Canadian population. High-risk food categories selected included baked goods, baking mixes, bread products, candies, cereal products, chocolate products, cookies, energy bars, sauces, savory biscuits, and snacks. The ED inducing an allergic reaction in 1% and 5% of the allergic population (ED01, ED05) for nine allergens (milk, egg, peanut, hazelnut, cashew, walnut, wheat, sesame, soy) were extracted from Houben et al., 2020. Action levels for the median (P50), 75th and 97.5th percentile consumption (P75, P97.5) of any food category investigated could be detected by commercial allergen detection kits when the ED05 was used. The P75 and ED05 were preferred to determine action levels because they were less conservative and more flexible. Allergen action levels set for use by food business operators (FBOs) as risk management tools in Canada would help standardize PAL use and make PALs more meaningful for Canadian FBOs and consumers. These values must be interpreted considering their limitations and assumptions and should accompany all efforts of prevention and management of allergen cross-contact.

Determination of Tropomyosin in Shrimp and Crab by Liquid Chromatography-Tandem Mass Spectrometry Based on Immunoaffinity Purification.

A UPLC-MS/MS method was developed for the detection of tropomyosin (TM) in shrimp and crab. After simple extraction, the samples were purified by immunoaffinity column and then digested by trypsin. The obtained sample was separated by Easy-nLC 1000-Q Exactive. The obtained spectrums were analyzed by Thermo Proteome Discoverer 1.4 software and then ANIQLVEK with high sensitivity was selected as the quantitative signature peptide. Isotope-labeled internal standard was used in the quantitative analysis. The method showed good linearity in the range of 5–5,000 μg/L with a limit of quantification (LOQ) of 0.1 mg/kg. The average recoveries were 77.22–95.66% with RSDs ≤ 9.97%, and the matrix effects were between 88.53 and 112.60%. This method could be used for rapid screening and quantitative analysis of TM in shrimp and crab. Thus, it could provide technical support for self-testing of TM by food manufacturers and promote further improvement of allergen labeling in China.

Precautionary Allergen Labelling in Serbia: Market Audit and Consumers' Perception.

Background:Precautionary allergen labels (PAL) should be used to indicate the possibility of allergen presence in the food. This study aimed to determine the prevalence and types of precautionary labeling statements on different pre-packaged food products in retail stores in Belgrade, Serbia, as well as to assess consumers’ attitudes and behavior towards PAL statements.Methods:This was a descriptive study. The following characteristics of 1404 pre-packaged foods were analyzed: prevalence of PAL, listed food allergens on PAL, and the types of the advisory terminology. In the group of 275 participants (94 with food allergies, and 181 persons who purchasing food for a household member with food allergy) reading practice of PAL, purchasing practice based on PAL, and the opinion about PAL statements credibility were evaluated.Results:Overall, 33.9% of products had precautionary statements for one or more allergens. “Tree nuts” were the most common allergens listed in the PAL. The most common type of PAL was “May contain traces of x [allergen]” (52.7%). The PAL was always read by half of the participants. Less than half (43.3%) of the participants incorrectly believed that PAL is regulated by national law. A quarter of participants thought that the PAL statements are trustworthy.Conclusion:PAL statements frequently are not user-friendly and are not providing sufficient protection for food allergic patients. To gain buyers’ confidence, protect health and provide security, the necessity for the strategies that would regulate PAL by the law exists.

Food Proteins in Human Breast Milk and Probability of IgE-Mediated Allergic Reaction in Children During Breastfeeding: A Systematic Review

Previous reports suggested that food proteins present in human milk (HM) may trigger symptoms in allergic children during breastfeeding, but existing evidence has never been reviewed systematically. To assess the probability of food proteins in HM to trigger allergic reactions in infants with IgE-mediated food allergy. Electronic bibliographic databases (MEDLINE, EMBASE) were systematically searched from inception to November 3, 2021. The data regarding the levels of food proteins detected in HM were extracted and compared with data from the Voluntary Incidental Trace Allergen Labelling (VITAL 3.0) guide to assess the probability of food-allergic individuals to experience immediate type allergic reactions on ingesting HM. A total of 32 studies were identified. Fourteen studies assessed excretion of cow's milk proteins into HM, 9 egg, 4 peanut, and 2 wheat; 3 measured levels of cow's milk and egg proteins simultaneously. We found that levels of all food proteins across the studies were much lower than the eliciting dose for 1% of allergic individuals (ED01) in most of the samples. The probability of an IgE-mediated allergic reaction in a food-allergic infant breastfed by a woman consuming the relevant food can be estimated as ≤1:1000 for cow's milk, egg, peanut, and wheat. To our knowledge, this is the first systematic review that assesses and summarizes evidence on food proteins in HM and potential for IgE-mediated allergic reactions. Our data suggest that the probability of IgE-mediated allergic reactions to food proteins in HM is low.

Analysis of Clinical Food Allergen Thresholds by Comparing Threshold Dose Distributions

Approaches to establish thresholds provided by oral food challenge (OFC) for food allergen labeling are held to be more important. Japan is one of the few countries that enables precautionary allergen labeling to be legally restricted by setting strict standards for total protein concentration (<10 μg/g). We collected OFC data and compared them using several different models to scientifically verify the validity of this labeling system.

Low dietary adherence after a positive food challenge in food allergic adults.

BackgroundAfter a positive food challenge (FC), patients receive dietary advice regarding avoidance of the culprit food. We examined the frequency and variables associated with dietary adherence after a positive FC in adults.MethodsIn this prospective daily practice study, adults with a positive FC were included. After every FC, dietary advice was given consisting of three options: (1) strict avoidance, (2) avoidance but products with precautionary allergen labelling (PAL) allowed and (3) (small) amounts allowed. Questionnaires about dietary adherence and associated variables were completed prior to and 6 months after the FC(s).Results41 patients (with 58 positive FCs) were included. Overall, patients adhered to the advised diet after 31% of the FCs. After 33 FCs, the advice was strict avoidance, whereof 82% followed a less strict diet. After 16 FCs, the advice was avoidance but products with PAL allowed, whereof 19% followed a less strict and 25% a stricter diet. In 9 FCs with the least strict advice, “(small) amounts allowed’’, 67% followed a stricter diet. Three variables were associated with adherence: misremembering dietary advice, impaired health‐related quality of life (HRQL) on domain “Emotional impact’’ and the need for dietary change after the FC.ConclusionAfter one third of the positive FCs, patients adhered to the dietary advice. Variables associated with adherence were misremembering dietary advice, impaired HRQL on domain “Emotional impact’’ and the need for dietary change after the FC. It seems important that healthcare professionals should more frequently apply adherence‐enhancing strategies to improve dietary adherence.

Allergen's labeling of food products: regulatory practices in Morocco

PurposeAllergenic substances cause food allergy, which represents a major health issue in most countries. This underlines the importance of considering the products' labeling as well as applying related regulatory practices. The objective of this study was to assess the labeling practices of allergens in food products in Morocco.Design/methodology/approachThis cross-sectional survey was conducted on 156 food products collected from four supermarkets in a Moroccan megacity. The data related to the allergen substances (allergen declared, emphasis characters, precautionary allergen labeling) were collected from labels of food products.FindingsThe number of foods included in this research was 156, of which 7 (4.5%) did not mention the allergy alert. The analysis of the allergy alert in the others sample (149) showed 266 nonconformities, noticed in 112 (71.8%) products. The labeling emphasis characters were observed in 33.3% of products, and only 13.5% mentioned “contains allergen” as a mandatory statement to declare the presence of allergens. Allergic alerts found in places concealed, removable by the opening of the seal or difficult to see were observed in 28.9%. The use of a precautionary allergen labeling statement was noticed in 40.4% of products.Originality/valueMoroccan regulations on food allergens are demanding like those of the European Union and more demanding than those of most African countries. However, the application of this regulation remains unsatisfactory and 266 non-conformities were found in 112 (71.8%) products. The absence of emphasis characters and the declaration in inappropriate places represent the most observed non-conformities. Therefore, Moroccan manufacturers must strictly adhere to regulations to avoid exposure of predisposed consumers to potentially threatening allergenic substances.

Glycation end products and technological aspects of reducing immunogenicity of specialized food products for nutrition of athletes

Food allergy, which affects about 8% of children and 5% of adults in the world, is one of the major global health problems, and allergen control is an important aspect of food safety. According to the FALCPA (Food Allergen Labeling and Consumer Protection Act of 2004 FDA), more than 160 foods can cause allergic reactions, with eight of them responsible for 90% of all food allergies in the United States, including milk, eggs, wheat, peanuts, soybeans, tree nuts, crustaceans and fish, also known as the Big 8. Most foods that are sources of obligate allergens are heat treated before consumption, which can trigger the Maillard reaction, which produces glycation end products. Symptoms of food sensitization are known to significantly affect the quality of life, gut microbial diversity and adaptation potential. In particular, in athletes, this can be expressed in a decrease in the effectiveness of the training process, which leads to poor endurance and athletic performance. In this regard, it seems relevant to study the effect of the Maillard reaction and AGEs on the immunogenicity of proteins and the possible relationship between these compounds and food allergy, as well as to develop measures to prevent the adverse effect of allergens on the body of a professional athlete and any other consumer.

Labeling food allergens in the packaged food pyramid groups in Brazil: analysis of descriptions, ambiguities, and risks.

ABSTRACTObjective:The aim of this study was to evaluate allergenic labeling components of packaged foods for “What is the quality of food labels?” and “What is the group of Brazilian Food Pyramid that ‘May contain’ is predominant?.”Methods:The photographs of 916 products were obtained, of which 518 were analyzed. Data from each label were evaluated according to Brazilian Food Pyramid Groups (i.e., Cereals, Fruits, & Vegetables; Soybean & products; Milk & dairy products; Meat & eggs; Fats & oils; and Sugars & sweets). Ten items were analyzed in each label, namely, the presence of a list of ingredients, alert phrase for allergy sufferers, grouping of the alert phrase, phrase location, uppercase phrase, the phrase in bold, the color of alert phrase contrasting to the background, adequate font size, do not claim the absence for any allergen with the ingredients, and others factors that make it difficult to read. For the second question, a structured questionnaire was completed, and products were classified into two categories, namely, “Contain” and “May contain.”Results:The quality of the label was appropriate, and 69% of packaged foods had at least one allergen. The information “May contain” were higher in cow’s milk (Cereals and Meat & eggs), soy (Soybean & products), and egg protein (Cereals). Soybean & products were the highest insecurity group.Conclusions:Brazilian health professionals can count on good-quality labeling of packaged products. Consequently, they could promote patients’ and parents/caregivers’ education to consult the labels and manage the risks in processed foods about precautionary allergen labeling. Soybean & products were the most significant insecurity for food choices between Brazilian Pyramid Groups.

ДОСЛІДЖЕННЯ АСОРТИМЕНТУ ТА ПОКАЗНИКІВ ЯКОСТІ І БЕЗПЕЧНОСТІ КРУП

The cereal market in Ukraine is quite diverse and is represented by both traditional and organic products. The largest producers of cereals in Ukraine are: “Cereal Planet Ukraine”, “Terra”, “HD-groups”, “GalaFoods”, “One hundred poods”, “Khutorok”. Analysis of the labeling of wheat groats Poltavska No. 2 TM “Gadyachanka” gives reason to believe that the manufacturer should pay attention to the labelling of allergens, as required by law and indicate the gluten content on the label. Groats of TM “Gadyachanka” correspond to regulatory documents on indicators of quality and safety. In wheat groats Poltavska No. 2 humidity is 8.8%, copper content – 0.12 mg/kg. Humidity of shelled peas is 5.4%, copper content – 0.24 mg/kg. Humidity of barley pearl barley is 6.4%, copper content – 0.2 mg/kg. Metal-magnetic impurities and pests were not detected in any sample of cereals. The amount of pesticides in all samples is lower than the sensitivity of the device. Further research is planned to be devoted to the scientific aspects of the implementation of the food safety management system based on the principles of HACCP in the production of cereals.

Threshold of Reactivity and Tolerance to Precautionary Allergen-Labelled Biscuits of Baked Milk- and Egg-Allergic Children

Extremely sensitive food-allergic patients may react to very small amounts of allergenic foods. Precautionary allergen labelling (PAL) warns from possible allergenic contaminations. We evaluated by oral food challenge the reactivity to a brand of PAL-labelled milk- and egg-free biscuits of children with severe milk and egg allergy. We explored the ability of proteomic methods to identify minute amounts of milk/egg allergens in such biscuits. Traces of milk and/or egg allergens in biscuits were measured by two different liquid-chromatography-mass spectrometry methods. The binding of patient’s serum with egg/milk proteins was assessed using immunoblotting. None of the patients reacted to biscuits. Egg and milk proteins were undetectable with a limit of detection of 0.6 µg/g for milk and egg (method A), and of 0.1 and 0.3 µg /g for milk and egg, respectively (method B). The immunoblots did not show milk/egg proteins in the studied biscuits. Milk/egg content of the biscuits is far lower than 4 µg of milk or egg protein per gram of product, the minimal doses considered theoretically capable of causing reactions. With high sensitivity, proteomic assessments predict the harmlessness of very small amount of allergens in foods, and can be used to help avoiding unnecessary PAL.